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[Delay in hospitalization, diagnosis and surgical intervention in acute appendicitis]
F R Martínez-De Jesús1, R Gallardo Hernández, M Morales Guzmán
1División de Cirugía, Centro Médico Nacional de Veracruz Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social.
Aims:
To assess if self-medication delays diagnosis and Surgical Treatment in acute appendicitis and increases morbidity, mortality and hospital stay as well.
Design:
Retrospective, comparative and observational study.
Statistics:
Chi square, exact Fisher test. SUBJECTS AND STUDY GROUPS: 57 patients were subjected to appendectomy and were stratified in three groups according to the lapse of time between initiation of symptoms and hospitalization: group A less than 24 h (n = 20), group B between 24 and 48 h (n = 17), and group C more than 48 h (n = 20).
Results:
Groups B and C showed a significant delay for both diagnosis (p < 0.001) and surgical intervention (p < 0.001) in relation to group A. The incidence of acute abdomen presentation showed a positive trend with time of hospitalization (p = 0.03). Self-medication increased from group A to C (p < 0.001). Groups B and C showed a complication rate of 24 and 25%, respectively (p > 0.05). Conversely, group A had not complications (p < 0.05). In addition there was a 5% mortality due to sepsis in group C. Finally, hospital stay was longer in groups B and C (p < 0.001).
Conclusions:
Self-medication correlated with delayed hospitalization, diagnosis, treatment and complications. Hospital stay was consequently longer.